Survival status and predictors of mortality from severe community-acquired pneumonia among under-five children admitted at Debre Tabor comprehensive specialized hospital: a prospective cohort study

Background

Globally, Pneumonia continues to be the leading cause of mortality among under-five children. Ethiopia ranks fourth out of 15 countries worldwide in terms of the highest death rate of under-five children due to severe community-acquired pneumonia (SCAP). However, to date, there is no recent study that shows survival status and predictors of mortality from SCAP. Therefore, this study aimed to determine survival status and predictors of mortality from this dangerous disease among under-five children.

Methods

A facility-based prospective cohort study was conducted from 1 November 2021 to 31 October 2022 at Debre Tabor comprehensive specialized hospital. All under-five children with SCAP admitted during the study period were included. Participants were selected using a systematic sampling technique. The collected data were coded, edited, and entered into epi-data version 4.2 and then exported to STATA version 17 for further analysis. The Kaplan Meier failure estimate with log-rank test was employed to determine the survival estimates. A cox-proportional hazard regression model was fitted to identify significant variables.

Results

The overall incidence density rate of mortality was 5.7 /1000 children with a median hospital stay of 8.2 days. Heart disease (AHR: 4.37; 95%CI: 1.68-11.32), previous admission of SCAP (AHR: 3.87; 95% CI: 1.31-11.43), WFL < -3Z score (AHR: 3.57; 95% CI: 1.02-12.42), impaired consciousness level at admission 3.41(1.14-10.19), and pleural effusion (AHR: 3.42; 95%CI: 1.18-9.93) were significant predictors of mortality.

Conclusion

In this study, the survival probability of children with SCAP was low. Children with heart disease, previous admission of SCAP, WFL < -3Z score, impaired consciousness level at admission, and pleural effusion had low survival. Therefore, much emphasis is needed on children with SCAP, particularly those with identified predictors.

Nursing students' attitudes and beliefs regarding sexual healthcare in Ethiopia: An online cross-sectional study

BACKGROUND

Unresolved sexual issues can have an impact on a person's wellbeing, social interactions, or even medication compliance. Given the enormous global demand to enhance and preserve sexual health, faculty members have a specific goal of developing nursing workforce who are truly prepared to work with clients who have sexual health issues. Hence, the study's purpose has been to evaluate the current state of attitude and belief of nursing students toward sexual healthcare and the factors that influence it in Southwest Ethiopia.

METHODS

An online cross-sectional survey was conducted in Mizan-Tepi University involving 134 undergraduate nursing students from February 1 to March 10, 2022. The Sexual Attitude and Beliefs Scale (SABS) were used to assess the level of attitudes and beliefs regarding sexual care. Statistical Package for Social Science (SPSS) Version 26 was employed for data analysis. Multivariable linear regression analyses was conducted to identify predictors of attitudes and beliefs regarding sexual healthcare. The significance level was set at p<0.05.

RESULTS

The mean age of the nursing students participating in this study was 28.47±5.2. In our study, mean SABS score of the nursing students was found as 42.3 ± 2.1. The mean score of the SABS items ranged from 1.68±0.93 to 4.37±1.48. Having receiving sexual health education (p<0.001) was significantly associated with attitude and beliefs regarding sexual healthcare.

CONCLUSIONS

Ethiopian nursing students have been found to have a negative attitude and beliefs about sexual health care. Because comprehensive sex education is sorely lacking in nursing schools, this scrutiny prevents student nurses from receiving an adequate education. As there is a lack of appropriate sexual health subject matter, it is critical to standardize sexual health education in nursing programs so that nursing students can learn to provide comprehensive care to clients.

Determinants of macrosomia among newborns delivered in northwest Ethiopia: a case–control study

Objective

Macrosomia is associated with the risk of mortality and morbidity in neonates and their mothers. Despite the considerable public health effect of macrosomia, evidence on the determinants of macrosomia is limited in Northwest Ethiopia in general and in Amhara region in particular. Therefore, this study aimed to identify determinants of macrosomia among newborns delivered in referral hospitals in 2020 in Amhara region, Northwest Ethiopia.

Methods

A facility-based unmatched case-control study was conducted among 279 mothers and their newborns in Amhara region referral hospitals. Newborns weighing 4000 g and above and between 2500 and 3999 g were considered cases and controls, respectively. Bivariable and multivariable binary logistic regression were used to identify the determinants of macrosomia.

Results

In total, 273 of 279 mothers and their newborns (97.8% response rate) were included. The mean birth weights of cases and controls were 4312.97 ± 357.53 g and 3161.92 ± 452.12 g, respectively. Weight gain over pregnancy, antenatal follow up, physical activity during pregnancy, and neonate sex were the main determinants of macrosomia.

Conclusion

The main determinants of macrosomia were determined in this study. Government should place special emphasis on reducing the modifiable factors of macrosomia.

Umbilical Cord Care Practices and Associated Factor Among Mothers of Neonates Visiting Mizan-Tepi University Teaching Hospital Southwest Ethiopia 2021

Background

Due to unsanitary cord care practices, cord infections are more common and prevalent in developing countries. In settings where mortality is low, dry and clean cord care is recommended for newborns delivered in health facilities or at home. Cord care practices would directly contribute to infection in newborns, accounting for a large proportion of millions of annual neonatal deaths. This study aimed to assess the cord care practices of mothers and to identify areas for intervention.

Methods

An institution-based cross-sectional study was conducted among mothers of neonates who gave birth in the last six months. Systematic random sampling technique was employed to include women who visited pediatric OPD and immunization clinics. Epi data version 3.1 was used to enter the data and then exported to SPSS version 26 for analysis. The association between the outcome and independent variables was examined using binary logistic regression. The strength of the association was measured using odds ratio (OR), 95% confidence intervals (CI) and p-value. Statistical significance was declared at a p-value <0.05.

Results

Four hundred twenty-two mothers were participated in the study. More than half (59.2%) of the respondents had good cord care practices, while nearly half (45.3%) mothers added nothing to the cord. Factors significantly associated with good cord care practices were educational status (AOR = 4.7; 95% CI = 1.34, 7.59), ANC follow-up (AOR = 3.58; 95% CI = 1.24, 10.32), initiation of breastfeeding (AOR = 1.74; 95% CI = 1.10, 2.77), and apply anything to the cord (AOR = 3.08; 95% CI = 1.92, 4.95).

Conclusion

The proportion of mothers with good cord care practices was inadequate. For such a high cause of neonatal death, prevention should be the priority intervention, and improving its implementation requires further effort.

Mechanisms, Pattern and Outcome of Pediatrics Trauma At Agaro General Hospital, Southwest Ethiopia, 2021

Introduction

Over 80% of trauma related deaths in children occur in low income and middle-income countries including Ethiopia. Trauma affects several aspects of child life and is still a major concern. Despite the Ethiopian federal ministry of health (FMoH) conducting away different trials, there was an increased burden and high projection of pediatric trauma. In Ethiopia, There is insufficient evidence about the mechanisms, patterns and outcomes of pediatric trauma including this study area, Therefore this study aimed to assess the mechanisms, patterns, and outcomes of pediatric trauma in Agaro General Hospital, Southwest Ethiopia, 2021.

Methods and Materials

This cross-sectional study was study conducted on randomly selected 405pediatric patients who visited the Agaro General Hospital between 1/1/2018 and 30/8/2021. Data were extracted from each medical chart using a structured checklist. Data were entered into Epi-data 4.4.2.1for cleaning and analyzed using SPSS version 24. Tables, charts, and text are used to report the results.

Results

A total of 405 patients were included in the study. This study revealed that majority 271 (66.9%) of injured children were males. Most 188 (46.4%) of the traumas were occurred on the street. Fall down injury were the most common 151(37.3%) cause of trauma, followed by road traffic accidents 98 (24.2%). Trauma caused by falls accounted for 43.7% and 34.4% % of all traumas in the 5–12 year and the <5 year age groups respectively. Most 126 (31.1%) of the subjects were exposed to head and face trauma. Majority 256 (63.2%) of children were discharged with improvement, while12 (3.0%) of them have died.

Conclusions

Pediatric trauma remains a major public health concern. Most of trauma occurred among boys and falldown injury was the most frequent trauma, and the majority of the subjects were exposed to head and face trauma. Therefore, children should receive safety precautions, more supervision, and identification of specific risk factors for these injuries, and should be prohibited from risky practices by concerned bodies including families and traffic officers.

Posttraumatic Stress Disorder, Suicidal Behavior, Substance Use, and Sexual Victimization Among Adolescent Girls Aged 10-19 Years Living Under Ethnic-Based Civil War in Ethiopia

BACKGROUND

Posttraumatic stress disorder (PTSD) is a chronic, impairing mental disorder that develops after exposure to a traumatic event. Despite many factors putting adolescent girls at risk of PTSD, little is known about the prevalence and how adolescent girls cope with the PTSD burden. So, this study aimed to investigate the prevalence of PTSD and associated factors among adolescent girls in three selected towns in Southwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted among 397 adolescent girls from May 27 to July 27, 2021. The participants were selected by a systematic random sampling method. PTSD and substance use disorder were assessed by DSM V criteria for mental disorders. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD.

RESULTS

The prevalence of PTSD among the adolescent girls was 22%, and about three in four (72.7%) of the adolescent girls developed PTSD after exposure to sexual violence. Furthermore, PTSD was associated with Khat use disorder (AOR, 95% CI: 2.79 (1.47-5.30), alcohol use disorder (AOR, 95% CI: 5.27 (2.21-12.60), and suicidal behavior (AOR, 95% CI: 2.12 (1.20-3.74)).

CONCLUSION

The prevalence of PTSD was high among adolescent girls, and suicidal ideation or attempt, khat use disorder, and alcohol use disorder were risk factors for PTSD. Therefore, early screening for PTSD and comorbid risk factors among this particular age group and managing accordingly is warranted.

Undernutrition and Its Associated Factors Among Human Immunodeficiency Virus Infected Children on Follow Up in Amhara Region Referral Hospitals, Ethiopia, 2020

Background. Undernutrition is a global problem and the biggest threat to human life and economic progress. It is the main cause of child morbidity and mortality especially in sub-Saharan Africa including Ethiopia. The severity of the problem is even worse when children are infected with human immunodeficiency virus. However the seriousness of the problem, there were limited studies conducted in the study area. Therefore, this study was conducted to assess the magnitude of undernutrition and its associated factors among HIV-infected children on follow up in Amhara Region Referral Hospitals. Methods. A facility-based cross-sectional study was conducted from February to April 2020. The data were collected through an interviewer-administered questionnaire. The collected data were coded and entered into Epi data 3.1 and exported to SPSS 26.0 for analysis. P-value <.05 was considered as statically significant. Results. The magnitude of undernutrition in this study was 30.3%. Dietary diversity (AOR = 1.73; CI 1.07-2.81), nutritional counseling (AOR = 2.42; CI 1.45-4.04), family size (AOR = 0.50; CI 0.27-0.93), WHO staging (AOR = 1.77; CI 1.08-2.88), and adherence to antiretroviral therapy (AOR = 1.75; CI 1.06-2.87) were predictors of undernutrition. Conclusions. Nearly one-third of the children included in this study had undernutrition. Poor dietary diversity, adherence to ART, nutritional counseling, family size, and WHO staging were factors significantly associated with undernutrition. Early screening and treatment of opportunistic infections, close attention to dietary counseling for caregivers and proper feeding habits will alleviate the problem.